S0125, Chemotherapy, Total-Body Irradiation, and Peripheral Stem Cell Transplantation in Treating Older Patients With Acute Myeloid Leukemia
S0125, A Phase II Study Of Chimerism-Mediated Immunotherapy (CMI) Using Nonmyeloablative Allogeneic Peripheral Blood Stem Cell Transplantation In Older Patients With Acute Myeloid Leukemia (AML) In First Complete Remission (A BMT Study)
RATIONALE: Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy and radiation therapy. Sometimes the transplanted cells can make an immune response against the body's normal tissues. Cyclosporine and mycophenolate mofetil may prevent this from happening.
PURPOSE: Phase II trial to study the effectiveness of chemotherapy and total-body irradiation followed by donor peripheral stem cell transplantation, cyclosporine, and mycophenolate mofetil in treating older patients who have acute myeloid leukemia.
調査の概要
詳細な説明
Primary objective:
- Determine whether allogeneic peripheral blood stem cell transplantation with pre-conditioning low dose total body irradiation and fludarabine followed by cyclosporine and mycophenolate mofetil, when given to elderly patients with acute myeloid leukemia in first complete remission, is sufficiently efficacious (in terms of survival 1 year after transplantation) to warrant a phase III investigation.
Secondary objective:
- Determine the frequency and severity of toxic effects of this regimen in these patients.
Other objectives as funding permits:
- Determine whether chimerism patterns in bone marrow and blood after transplantation are associated with relapse and/or graft-versus-host disease (GVHD) in these patients.
- Determine whether cytogenic, immunophenotypic, and molecular biologic features detected in pre- and post-transplantation specimens are related to transplant outcomes and risk of relapse in these patients.
OUTLINE: This is an open-label study.
- Conditioning regimen: Patients receive fludarabine IV over 1 hour on days -4 to -2. Patients also undergo total body irradiation on day 0.
- Peripheral blood stem cell infusion (PBSC): Patients receive unmodified filgrastim transplantation (G-CSF)-mobilized donor PBSC on day 0.
- Post-transplantation immunosuppression: Patients receive oral cyclosporine on days -3 to 35 followed by a taper until day 180. Patients also receive oral mycophenolate mofetil on day 0 to 27 without tapering.
- Donor lymphocyte infusions (DLI): Patients with relapsed disease receive DLI IV over 30 minutes for up to 2 infusions.
Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually for 3 years.
PROJECTED ACCRUAL: A total of 25-51 patients will be accrued for this study.
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
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Arizona
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Phoenix、Arizona、アメリカ、85006
- Banner Good Samaritan Medical Center
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Tucson、Arizona、アメリカ、85723
- Veterans Affairs Medical Center - Tucson
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Tucson、Arizona、アメリカ、85724
- Arizona Cancer Center at University of Arizona Health Sciences Center
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Arkansas
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Little Rock、Arkansas、アメリカ、72205
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
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Little Rock、Arkansas、アメリカ、72205
- Veterans Affairs Medical Center - Little Rock
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California
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Duarte、California、アメリカ、91010-3000
- City of Hope Comprehensive Cancer Center
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La Jolla、California、アメリカ、92037-1027
- Scripps Cancer Center at Scripps Clinic
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Los Angeles、California、アメリカ、90033
- USC/Norris Comprehensive Cancer Center and Hospital
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Los Angeles、California、アメリカ、90095-1678
- Jonsson Comprehensive Cancer Center at UCLA
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Martinez、California、アメリカ、94553
- Veterans Affairs Outpatient Clinic - Martinez
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Orange、California、アメリカ、92868
- Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
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Sacramento、California、アメリカ、95816
- Sutter Cancer Center
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Sacramento、California、アメリカ、95817
- University of California Davis Cancer Center
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Stanford、California、アメリカ、94305-5408
- Stanford Cancer Center at Stanford University Medical Center
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Travis Air Force Base、California、アメリカ、94535
- General Robert Huyser Cancer Center at David Grant Medical Center
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Walnut Creek、California、アメリカ、94598
- John Muir/Mt. Diablo Comprehensive Cancer Center
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Colorado
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Aurora、Colorado、アメリカ、80010
- University of Colorado Cancer Center at University of Colorado Health Sciences Center
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Denver、Colorado、アメリカ、80220
- Veterans Affairs Medical Center - Denver
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Florida
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Tampa、Florida、アメリカ、33612
- Veterans Affairs Medical Center - Tampa (Haley)
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Georgia
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Atlanta、Georgia、アメリカ、30342-1701
- CCOP - Atlanta Regional
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Decatur、Georgia、アメリカ、30033
- Charles B. Eberhart Cancer Center at DeKalb Medical Center
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Fort Gordon、Georgia、アメリカ、30905-5650
- Dwight David Eisenhower Army Medical Center
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Hawaii
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Honolulu、Hawaii、アメリカ、96813
- Cancer Research Center of Hawaii
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Honolulu、Hawaii、アメリカ、96813
- MBCCOP - Hawaii
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Idaho
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Boise、Idaho、アメリカ、83712
- Mountain States Tumor Institute - Boise
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Illinois
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Chicago、Illinois、アメリカ、60612
- Veterans Affairs Medical Center - Chicago Westside Hospital
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Hines、Illinois、アメリカ、60141
- Veterans Affairs Medical Center - Hines
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Maywood、Illinois、アメリカ、60153-5500
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
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Indiana
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Beech Grove、Indiana、アメリカ、46107
- Indiana Blood and Marrow Transplantation
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Kansas
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Kansas City、Kansas、アメリカ、66160-7353
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
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Wichita、Kansas、アメリカ、67214-3882
- CCOP - Wichita
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Wichita、Kansas、アメリカ、67218
- Veterans Affairs Medical Center - Wichita
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Kentucky
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Lexington、Kentucky、アメリカ、40502-2236
- Veterans Affairs Medical Center - Lexington
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Lexington、Kentucky、アメリカ、40536-0084
- Markey Cancer Center at University of Kentucky Chandler Medical Center
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Louisiana
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New Orleans、Louisiana、アメリカ、70112
- Veterans Affairs Medical Center - New Orleans
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New Orleans、Louisiana、アメリカ、70112
- MBCCOP - LSU Health Sciences Center
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New Orleans、Louisiana、アメリカ、70115
- New Orleans Cancer Institute at Memorial Medical Center
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New Orleans、Louisiana、アメリカ、70112
- Tulane Cancer Center at Tulane University Hospital and Clinic
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Shreveport、Louisiana、アメリカ、71130-3932
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
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Shreveport、Louisiana、アメリカ、71101-4295
- Veterans Affairs Medical Center - Shreveport
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Massachusetts
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Boston、Massachusetts、アメリカ、02114
- Massachusetts General Hospital Cancer Center
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Boston、Massachusetts、アメリカ、02118
- Cancer Research Center at Boston Medical Center
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Michigan
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Ann Arbor、Michigan、アメリカ、48109-0948
- University of Michigan Comprehensive Cancer Center
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Detroit、Michigan、アメリカ、48201-1379
- Barbara Ann Karmanos Cancer Institute
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Detroit、Michigan、アメリカ、48201-1932
- Veterans Affairs Medical Center - Detroit
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Detroit、Michigan、アメリカ、48202
- Josephine Ford Cancer Center at Henry Ford Health System
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Southfield、Michigan、アメリカ、48075
- Providence Cancer Institute at Providence Hospital - Southfield Campus
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Mississippi
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Jackson、Mississippi、アメリカ、39216-4505
- University of Mississippi Medical Center
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Jackson、Mississippi、アメリカ、39216
- Veterans Affairs Medical Center - Jackson
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Missouri
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Kansas City、Missouri、アメリカ、64131
- CCOP - Kansas City
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Saint Louis、Missouri、アメリカ、63110
- Saint Louis University Cancer Center
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Montana
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Billings、Montana、アメリカ、59101
- CCOP - Montana Cancer Consortium
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New Mexico
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Albuquerque、New Mexico、アメリカ、87108-5138
- Veterans Affairs Medical Center - Albuquerque
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New York
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Albany、New York、アメリカ、12208
- Veterans Affairs Medical Center - Albany
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New York、New York、アメリカ、10016
- NYU Cancer Institute at New York University Medical Center
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New York、New York、アメリカ、10032
- Herbert Irving Comprehensive Cancer Center at Columbia University
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Rochester、New York、アメリカ、14642
- James P. Wilmot Cancer Center at University of Rochester Medical Center
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Ohio
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Cincinnati、Ohio、アメリカ、45220-2288
- Veterans Affairs Medical Center - Cincinnati
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Cleveland、Ohio、アメリカ、44195-9001
- Cleveland Clinic Taussig Cancer Center
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Dayton、Ohio、アメリカ、45429
- CCOP - Dayton
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Dayton、Ohio、アメリカ、45428-1002
- Veterans Affairs Medical Center - Dayton
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Oklahoma
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Oklahoma City、Oklahoma、アメリカ、73104
- Veterans Affairs Medical Center - Oklahoma City
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Oklahoma City、Oklahoma、アメリカ、73104
- Oklahoma University Medical Center
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Oregon
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Portland、Oregon、アメリカ、97225
- CCOP - Columbia River Oncology Program
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Portland、Oregon、アメリカ、97201-3098
- Cancer Institute at Oregon Health and Science University
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South Carolina
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Charleston、South Carolina、アメリカ、29401-5799
- Veterans Affairs Medical Center - Charleston
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Greenville、South Carolina、アメリカ、29615
- CCOP - Greenville
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Tennessee
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Memphis、Tennessee、アメリカ、38104
- University of Tennessee Cancer Institute at Methodist Central Hospital
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Texas
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Amarillo、Texas、アメリカ、79106
- Veterans Affairs Medical Center - Amarillo
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Houston、Texas、アメリカ、77030
- Baylor College of Medicine
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Lackland Air Force Base、Texas、アメリカ、78236-5300
- Wilford Hall Medical Center
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Lubbock、Texas、アメリカ、79415-3364
- UMC Southwest Cancer and Research Center
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San Antonio、Texas、アメリカ、78229-3900
- University of Texas Health Science Center at San Antonio
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San Antonio、Texas、アメリカ、78229
- Veterans Affairs Medical Center - San Antonio (Murphy)
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Temple、Texas、アメリカ、76504
- Veterans Affairs Medical Center - Temple
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Utah
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Salt Lake City、Utah、アメリカ、84148
- Veterans Affairs Medical Center - Salt Lake City
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Salt Lake City、Utah、アメリカ、84132
- Huntsman Cancer Institute At University of Utah
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Washington
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Seattle、Washington、アメリカ、98101
- CCOP - Virginia Mason Research Center
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Seattle、Washington、アメリカ、98108
- Veterans Affairs Medical Center - Seattle
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Seattle、Washington、アメリカ、98109-1024
- Fred Hutchinson Cancer Research Center
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Seattle、Washington、アメリカ、98104
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
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Tacoma、Washington、アメリカ、98431-5000
- Madigan Army Medical Center
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Tacoma、Washington、アメリカ、98405-0986
- CCOP - Northwest
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
- Morphologically confirmed acute myeloid leukemia (AML) (within 180 days of diagnosis) OR
- Secondary AML (secondary to myelodysplastic syndromes (MDS) or to prior leukemogenic therapy)
- Must have A1 marrow, B1 blood, and C1 extramedullary disease status
- Must have received prior remission induction chemotherapy
- Must have a genotypically HLA-identical sibling donor available that is not a monozygotic identical twin
- No M3 AML or blastic transformation of chronic myelogenous leukemia
- If history of CNS leukemia, no leukemia cells in CNS by lumbar puncture within past 7 days
- Must be concurrently enrolled on protocols SWOG-9007 and SWOG-S9910
PATIENT CHARACTERISTICS:
Age
- 55 to 69
Performance status
- Zubrod 0-2
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Not specified
Renal
- Not specified
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
No other malignancy within the past 2 years except for the following:
- Adequately treated basal cell or squamous cell skin cancer
- Carcinoma in situ of the cervix
- Adequately treated stage I or II cancer in complete remission
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior allogeneic hematopoietic stem cell transplantation
Chemotherapy
- See Disease Characteristics
- Prior consolidation therapy allowed
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Prior organ transplantation allowed provided not concurrently receiving immunosuppressive therapy
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:treatment
patient conditioning - fludarabine 30 mg/m2 IV over 1 hour Days -4, -3, -2; TBI 6-7 cGy/min Day 0 post-transplant immunosuppression - cyclosporine 6.25 mg/kg bid PO D -3 to +180 (begin taper on D+35); mycophenolate mofetil 15mg/kg bid PO D0 to +27
|
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Overall Survival
時間枠:1 year
|
measured from date of registration to study until death from any cause with patients still alive censored at date of last contact
|
1 year
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Serious Adverse Events
時間枠:9 months
|
Twice a week for the first two months, one time a week during month 3, one time every two weeks for months 4-9.
|
9 months
|
協力者と研究者
スポンサー
捜査官
- スタディチェア:Peter McSweeney, MD、Rocky Mountain Cancer Centers - Denver Midtown
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- S0125 (その他の識別子:SWOG)
- U10CA032102 (米国 NIH グラント/契約)
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。